How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $234.42 Median $630.96 Typical High $741.31 | Facility | None | $234.42 | $630.96 | $741.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $42.66 Median $446.68 Typical High $616.60 | Professional | None | $42.66 | $446.68 | $616.60 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $54.95 Median $100.00 Typical High $158.49 | Facility | None | $54.95 | $100.00 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $407.38 | Facility | None | $120.23 | $194.98 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Fallon Health Setting Facility Modifier None Typical Low $31.62 Median $263.03 Typical High $691.83 | Facility | None | $31.62 | $263.03 | $691.83 |
Fallon Health Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $389.05 | Professional | None | $239.88 | $288.40 | $389.05 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $53.70 | Professional | None | $36.31 | $42.66 | $53.70 |
Mass General Brigham Setting Facility Modifier None Typical Low $234.42 Median $630.96 Typical High $741.31 | Facility | None | $234.42 | $630.96 | $741.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $42.66 Median $446.68 Typical High $616.60 | Professional | None | $42.66 | $446.68 | $616.60 |
United Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Well Sense Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $302.00 | Facility | None | $151.36 | $213.80 | $302.00 |
Well Sense Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $208.93 | Professional | None | $151.36 | $151.36 | $208.93 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Where Massachusetts sits
The same service costs 2.6 times more in Texas than in Connecticut. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 3rd of 51
$93.33
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.